Provider Demographics
NPI:1013638444
Name:MAY, KIMBERLY EMIA (NP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:EMIA
Last Name:MAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BURNING TREE PL
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8619
Mailing Address - Country:US
Mailing Address - Phone:478-456-0003
Mailing Address - Fax:
Practice Address - Street 1:22 BURNING TREE PL
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-8619
Practice Address - Country:US
Practice Address - Phone:478-456-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208873363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology